GERD - (GastroEsophageal) REFLUX (Disease) in Esophageal Atresia Patients: An ERNICA animation

GERD GERD, gastroesophageal reflux disease in esophageal atresia patients. An Ernica animation for parents and families. Esophageal atresia is a rare birth defect where a part of the esophagus, the tube connecting the mouth to the stomach, is missing. This animation aims to show you what gastroesophageal reflux disease is and how it is treated for children born with oesophageal atresia. All patients born with oesophageal atresia should be treated at a specialist center with a multidisciplinary team, which is a team of different clinical professionals. Peer support can be accessed through patient and family support groups. Patients with oesophageal atresia may experience gastroesophageal reflux disease at points throughout their life after their esophagus has been surgically repaired. What is gastroesophageal reflux disease? Gastroesophageal reflux is when food and acid from the stomach flows back into the esophagus. This is a physiological condition common in infants. Milk or food is regurgitated, which is when it comes back up into the mouth after feeding. Gastroesophageal reflux becomes a disease when troublesome symptoms and or complications are experienced. For example, the reflux can accidentally enter the airway and the lungs. This is known as aspiration, and it can lead to irritation and lung infections. Gastroesophageal reflux may also irritate the inside wall of the esophagus, and in particular, the area where the esophagus was repaired during surgery. What are the signs of reflux? In children with gastroesophageal reflux, milk or food comes back up into the mouth without effort after feeding. More rarely, they may vomit after feeds. They may also find it difficult to gain weight and have frequent lung infections. For some children, the esophagus may narrow in the area where surgery was performed to repair it. It may also be the case that a child shows no external signs at all. It is important to discuss any symptoms and changes with your child's clinical team, as they could be a sign of reflux or something else. Working together with your clinical team is important to look at the possible causes of these symptoms. Follow up care should be provided, and this should be both lifelong and structured. What treatments are available for reflux of oesophageal atresia? Medication can be used to treat gastroesophageal reflux. A common medication is proton pump inhibitors, or PPIs. This medication is swallowed, and it works by blocking and reducing the production of stomach acid. Contents of the stomach still rise up to the mouth, but there is less stomach acid, and therefore less irritation. If PPI medication is reduced or stopped, this should be done under the guidance of your child's clinical team. For some patients, a surgical procedure can be performed to treat gastroesophageal reflux disease, called fundoplication. This surgical procedure aims to tighten the valve at the top of the stomach to stop stomach acid from rising up. How is reflux monitored? Reflux can be monitored by performing a test called a 24 hour PH study. A thin tube is inserted into the child's nostril and carefully placed down the back of the throat and into the esophagus. The tube measures the amount and strength of acid reflux in the esophagus over a 24 hour period. An impedance study can be performed at the same time. This measures non-acidic reflux in the esophagus. These tests should be carried out according to a specific schedule. You might not realize that your child is experiencing gastroesophageal reflux disease at all. Monitoring reflux is very important.